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目的探讨吡格列酮对2型糖尿病合并脑梗死患者颈动脉IMT的影响。方法将入选的60例糖尿病合并脑梗死患者随机分为吡格列酮治疗组和常规治疗组,应用彩色超声诊断仪检测IMT,并检测两组治疗前后血糖、血脂、HOMA-IR、血清hs-CRP、MMP-9水平。结果①吡格列酮治疗12周时颈动脉IMT较治疗前及同期对照组均显著变小(P<0.05),血清hs-CRP、MMP-9、FPG、HbA1c、TC、TG、LDL-C、HOMA-IR亦显著降低(P<0.05)。HDL-C水平明显增加(P<0.05)。②Pearson相关分析显示颈动脉IMT分别与年龄、FPG、LDL-C、SBP、HOMA-IR、hs-CRP、MMP-9呈正相关(P<0.05)。结论吡格列酮能有效降低血清hs-CRP、MMP-9水平,减轻血管炎性反应,减少颈动脉内膜中层厚度,有益于糖尿病合并脑梗死等大血管病变的防治。
Objective To investigate the effect of pioglitazone on carotid IMT in type 2 diabetic patients with cerebral infarction. Methods Sixty patients with diabetes mellitus complicated with cerebral infarction were randomly divided into two groups: pioglitazone group and conventional treatment group. Color IMT was used to detect IMT. Blood glucose, blood lipids, HOMA-IR, serum hs-CRP, MMPs -9 level. Results ① The IMT of carotid artery in pioglitazone treatment group was significantly lower than that of the control group before and at 12 weeks (P <0.05), and the serum levels of hs-CRP, MMP-9, FPG, HbA1c, TC, TG, LDL- IR also decreased significantly (P <0.05). HDL-C levels increased significantly (P <0.05). ②Pearson correlation analysis showed that carotid IMT was positively correlated with age, FPG, LDL-C, SBP, HOMA-IR, hs-CRP and MMP-9. Conclusion Pioglitazone can effectively reduce the serum levels of hs-CRP and MMP-9, reduce vascular inflammatory response, reduce the intima-media thickness of the carotid artery and prevent and cure macrovascular complications such as diabetes mellitus and cerebral infarction.